Paper Explores Whether Lou Gehrig Experienced a Temporary ALS Reversal in 1938

For three weeks during Lou Gehrig’s final season, the baseball legend appeared to shake off his symptoms of amyotrophic lateral sclerosis (ALS) and regain his flagging prowess.

Richard Bedlack, MD, PhD, founder and director of Duke University’s ALS clinic, and baseball author Dan Joseph, provide an analysis of this episode from the Iron Horse‘s last full season with the New York Yankees. in 1938. They suggest that Gehrig may have experienced a temporary ALS reversal, which might provide useful insights for researchers and those coping with the disorder.

Their analysis, “A Great Yankee’s Indian Summer: Did Lou Gehrig Experience a Temporary ALS Reversal While Playing in August 1938?,” was published in RRNMF Neuromuscular Journal.

Despite being referred to by some scientists as “relentlessly progressive,” ALS patients occasionally experience periods of stability, called “plateaus,” and even of improvement, called “reversals.”

Reversals are typically brief and small in magnitude, although very rare large and persistent reversals have been reported.

Gehrig’s symptoms began in 1938 as he opened what would become his final season in a deep slump. He ended that season with the uncharacteristically low statistics of a .295 batting average (Gehrig’s career average was .340), 29 home runs, and 114 runs batted in (RBI).

Beginning on Aug. 7, however, the slump briefly appeared to end. Over three weeks, his batting average rose to .352, with six home runs and 22 RBI during one 10-game stretch. Throughout the 24 games played during that stretch, Gehrig hit nearly one-third of his home runs and RBI for the season.

Sports writers at the time noted that Gehrig was injury-free during that period, after having played with a fractured thumb during part of July; that he used a lighter bat, which could have allowed him to swing faster and hit the ball with greater force; and that he returned to his traditional batting stance after experimenting with other stances.

Bedlack and Joseph, however, point out that Gehrig was in good orthopedic health throughout most of that season and that players regularly experimented with different bats and stances.

The two authors suggest that Gehrig’s slugging percentage provides an even more telling measure of that summer’s reversal.

The slugging percentage represents players’ total number of bases divided by their at-bats. The more extra-base hits — doubles, triples, and home runs — they get, the higher their slugging percentage.

In the ’38 season running up to Aug. 7, Gehrig’s slugging percentage stood at a low .486. This exploded to .743 during his three-week surge, after which it once again fell, dropping to .436. Gehrig was hitting mostly singles during this time, which the authors take as a sign of his diminishing power.

Bedlack and Joseph’s analysis also effectively dispenses with the concept of a “hot streak” and the possibility of having faced a string of mediocre pitchers, both of which had been put forward to explain Gehrig’s three-week run.

To these authors, a temporary ALS reversal better explains Gehrig’s surge.

The weakness associated with ALS occurs when the rate of motor neurons’ death overwhelms the body’s ability to compensate by growing new neurons, known as reinnervation. Several ALS models have shown evidence that this process can be affected by either a slowdown of motor neuron death or by temporary reinnervation.

Gehrig may have experienced one or both of these factors, the authors argue, during that three-week stretch.

The so-called Indian Summer of Lou Gehrig’s 1938 season may provide a useful reference when educating newly-diagnosed ALS patients about the disorder’s non-linear progression and about what one may accomplish despite their condition.

“[T] temporary and especially dramatic and sustained ALS reversals may be worth studying,” the authors concluded. “[I]f we can understand why these occur, we may someday be able to make them happen more often.”